Is Somatic Therapy Covered by Insurance? Navigating Coverage Options

Navigate the complexities of insurance coverage for somatic therapy

Seeking mental health support can be a significant step towards well-being, but understanding insurance coverage can often be confusing. If you're considering somatic therapy, you might be wondering, "Is somatic therapy covered by insurance?" This article will help you navigate the complexities of insurance coverage for somatic therapy and explore your options for accessing affordable care.

The Complexities of Mental Health Insurance Coverage

Mental health coverage varies significantly depending on your insurance plan, state regulations, and the specific type of therapy you're seeking. While the Mental Health Parity and Addiction Equity Act (MHPAEA) aims to ensure that mental health benefits are comparable to physical health benefits, navigating these regulations can still be challenging.

Does Insurance Cover Somatic Therapy?

Whether your insurance covers somatic therapy depends on several factors:

• Your Insurance Plan: Different plans have different levels of coverage for mental health services. Some plans may cover somatic therapy directly, while others may not.
• The Therapist's Credentials: Insurance companies typically require therapists to be licensed mental health professionals (e.g., LCSW, LPC, LMFT, Psychologist) to be eligible for reimbursement. If your somatic therapist is also a licensed mental health professional, coverage is more likely.
• The Diagnostic Code: Insurance companies often require a diagnostic code (from the DSM-5) to justify coverage for therapy. If your somatic therapy is addressing a diagnosed mental health condition (e.g., PTSD, anxiety), coverage is more likely.
• In-Network vs. Out-of-Network Providers: If your therapist is in-network with your insurance plan, your costs will typically be lower. If they are out-of-network, you may have higher out-of-pocket expenses, but you might be able to submit claims for partial reimbursement.

How to Check Your Coverage

The best way to determine your coverage for somatic therapy is to contact your insurance provider directly. Here are some questions to ask:

• "Does my plan cover somatic therapy?"
• "Are there any specific requirements for coverage (e.g., pre-authorization, diagnostic code)?"
• "Are there any in-network somatic therapists in my area?"
• "What are my out-of-network benefits for mental health services?"
• "What is my deductible, co-pay, and co-insurance for mental health services?"

Options for Out-of-Network Coverage

If your therapist is out-of-network, you may still be able to receive some reimbursement for your sessions. Here's how:

• Submit Claims: You can submit claims to your insurance company for reimbursement. They will typically reimburse a percentage of the allowed amount for out-of-network services.
• Use a Superbill: Your therapist can provide you with a superbill, which is a detailed invoice that includes all the necessary information for submitting a claim.

Other Options for Affordable Somatic Therapy

If insurance coverage is limited or unavailable, here are some other options for accessing affordable somatic therapy:

• Sliding Scale Fees: Some therapists offer sliding scale fees based on income.
• Community Mental Health Centers: These centers often provide low-cost or free mental health services.
• Non-Profit Organizations: Some non-profit organizations offer grants or subsidies for mental health treatment.

Don't Let Cost Be a Barrier

Seeking mental health support is an investment in your well-being. Don't let cost be a barrier to accessing the care you need. Explore your options, communicate with your insurance provider, and consider alternative resources to find affordable somatic therapy.

ABOUT THE AUTHOR

Dr. Chelsea

Chelsea Levenson PhD, Clinical Psychologist, specializes in creating safe, trusting space for clients on their journey toward healing. She specializes in somatic therapy and improving the mind-body connection. She is trained in trauma-focused modalities including Hakomi Somatic Therapy, EMDR, and IFS. She believes self-compassion, reflection, and awareness are keys to create lasting change. She worked in private practice, and intensive trauma treatment settings, including residential, PHP, and IOP levels of care.